Plantar (plantar ) fasciitis:causes, treatment and prevention
Plantar fasciitis — it is easier to prevent than to cure
Plantar fasciitis is a disease that develops slowly and the early stages he was not paying attention.
I think that the pain or tension will take place after the leg rest. But, over time, the pain in the sole is amplified after the holidays.
The occurrence of the disease is observed much the bowl in women than in men, athletes, the elderly.
Anatomy of the foot
The lower limbs and the only body support and movement human Structure of the foot is designed to bear a load when walking upright.
It consists of 26 bones, joints, muscles, tendons, fat pads, arteries and veins, nerve endings. The largest bone is the heel bone.
The calcaneal tuberosity is the main attachment site for tendons and muscles on the foot. To the heel bone is attached to the fascia. It’s a powerful connective tissue plate which from a top of the calcaneus extends across the sole over the muscles and attaches four rays to the bones of the toes.
Fascia refers to the connective tissues and is taut as a bowstring, supports longitudinal arch of the foot, adjusting the load on the foot when walking.
Half the weight of the human body occurs in the heel area and creates a load on the plantar fascia. The maximum stress occurs at the point of its attachment to the calcaneal tuber.
Causes and risk factors
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In connection with the excessive stress on this area can cause microtrauma to the fascia, which in most cases spontaneously heal, if the person alternates between load and rest.
However, there are a number of cases in which the load on the foot increases.
Main reasons why developing and progressing plantar fasciitis:
- When wearing mismatched shoes, prolonged standing on his feet, weightlifting and other power sports, excess weight develops flat feet.
- Age-related degenerative changes reduce the thickness of subcutaneous adipose tissue in the heel region. It is the result of deterioration of the blood microcirculation and slow down the regenerative processes of the body.
- The formation of a valgus position of the first toe arthritis, (bone goes inside, and the finger curves outward) is the first signal that the foot is in the wrong position, consequently the heel becomes overloaded and there is a risk of occurrence of plantar fasciitis.
- Poor circulation and metabolic processes, which is caused by gout (causes excess deposits of salts), atherosclerosis, diabetes.Infectious diseases (gonorrhea, hlamidoz) and appears in a long time (at least several months)
- Physical trauma of the calcaneus, sprain and joint diseases as a result of which the load is removed from the injured leg and carried on a healthy, which is beginning to experience overload.
Fascia is constantly irritated a bone and an inflammatory aseptic (amicrobic) process on calcaneal tuber on the heel.
This process underlies the heel fasciitis. As disease progression occurs ossification of the inflamed tissue is formed and bone growth. Cause pain chronic inflammation of the heel area of the foot.
What is the disease?
The leading symptom is pain. The pain in the heel is most often on the plantar surface, at least – on a back surface of the bone.
The pain occurs at first due to the inflammatory process and eventually because of bone growth resembling a spike. Especially sharp, not giving to become on the foot, it happens in the morning or after rest.
Cause once again breaks the damaged sections of the fascia, which began to coalesce during sleep. Day the pain becomes less, but the evening is enhanced.
If the disease goes into a chronic form with the formation of heel spurs, man tries to walk on in socks or outer part of the foot but not the heel.
When inflammation of the fascia or the occurrence of spurs touched on both feet without crutches or a cane can not do.
The preliminary diagnosis put on the basis of complaints and superficial palpation of the metatarsal area.
X-ray shows the magnitude of the spike and gives the opportunity to determine treatment.
Methods of treatment
Method of treatment depends on the diagnosis, and are aimed primarily at pain relief.
Before starting treatment, it is important to determine what the reason for plantar fasciitis and direct all efforts to eliminate it.
In inflammatory processes without the formation of bony outgrowth prescribers (non-steroidal anti-inflammatory or homeopathic) to eliminate inflammation of the tissue around the calcaneal tuber and increasing elasticity of ligaments.
If the ligaments stretch, even the presence of a spur does not cause acute pain. Non-steroidal anti-inflammatory remedies that reduce the pain and in small doses is attributed for a long time.
Assigned to local treatment with ointments, compresses.
A good result in of plantar fasciitis is the result of application of physical treatments
- Magnetic resonance therapy aimed at the removal of edema, inflammation, improve blood circulation.
- Shock-wave therapy. The influence of acoustic waves of high frequency on soft tissues of the foot. In the process of acupressure the blood circulation is stimulated in the heel area, and eliminates inflammation, relieves pain with exertion, strengthening tendons and ligaments, the spur is resolved. The effect of this method is equal surgery.
- Laser (quantum) therapy. The laser beam acts directly on the subcutaneous tissue. Relieves inflammation, swelling, activates the regenerative processes.
- Radiotherapy. Aims to eliminate the pain due to blocking x-ray beam of low dosage radiation of the nerve endings.
- Phonophoresis. A holistic approach combining medical and physical impact. Using ultrasound with hydrocortisone ointment is introduced into the tissues of the heel region. Such penetration of the ointment provides strong anti-inflammatory effect. This leads to increased, microcirculate of blood, improve metabolism in cells, lymph drainage.
Surgery as an extreme method of therapy
The lack of results in the conservative treatment leads to surgical intervention. Statistics showed that only about 70% of transactions are effective.
The recurrence of the disease is not observed. The operation is performed under local anesthesia. An anesthetic is injected into the spinal cord and blocks the sensitivity of the lower extremities.
Using miniature surgical instruments allows surgeons, in addition to traditional open surgery, to perform endoscopic surgery and minimally invasive dissection of the fascia, which is less traumatic and easier tolerated by patients.
Endoscopic surgery is performed using miniature surgical instruments and a camera that helps to monitor the progress of the operation.
Minimally invasive dissection of the fascia is carried out using microscopic scalpel attached to the end of thin tubes.
With it cut off the fascia. After that, the scalpel is replaced by the mill, which grinds off the bone spike. The operation is performed under control of x-ray equipment.
Depending on the type of operation to rehabilitation takes time. The minimum period needed after minimally invasive dissection of the fascia.
But it does not mean that the affected leg can become in the near future. Besides is possible in extreme cases of postoperative complications:
- increased pain;
- injury to the nerve during surgery;
- suppuration of the wound or its healing;
- ducation neuroma (a benign tumor) of large nerve cells.
Treatment of plantar fasciitis at home is conservative, requires regularity and takes a long time. Applicable at early stages of the disease.
It includes compresses, rubbing, baths, lotion use paraffin, ozokerite, sea salt, herbs and ointments of their own making.
All procedures should be done in the evening before bed. Duration – until the pain disappears.
Use tools such:
- Sea salt. For bath dissolve 1 kg of salt per 5L of hot water. Feet to keep up to complete cooling solution. Trace elements of salt, penetrating through the pores of the skin can improve the elasticity of the ligaments of the foot.
- Paraffin and ozokerite (mountain wax) are used together in applications, which are well heated tissue of the foot and have them trace elements. The temperature of the heated mass should be about 40 degrees. It should be put on the foot, wrap a linen cloth, with polythene and wrap a warm blanket. To warm up the foot for 30 minutes. After the procedure, wear warm socks.
- Medical bile. To put a compress on a steamed foot of linen, impregnated with bile. Wrap the polyethylene, to fix and put on a sock. In the morning, wipe the foot with alcohol.
- Bischofite. Natural salt brine rich in minerals (iron, magnesium, silicon, etc.) is extracted from deep rock when drilling oil wells. Rubbed into the skin is warmed the heel region of the foot. After rubbing the brine applied to the crushed pieces gauze cloth moistened with iodine, cover with polyethylene, fix with an elastic bandage and wear wool socks.
- Since ancient times, disease was treated with tincture of lilac (flowers pour vodka and insist in a dark place for 10 days) taking 30 drops inside and rubbing the heel region of the foot several times a day. And applying fresh leaves of burdock, plantain, cabbage, horseradish, pulp of raw potato and black radish, changing them throughout the day at least three times.
To treatment of plantar fasciitis at home be effective you need to adhere strictly to the recommended dosages.
How to prevent the disease?
Should follow these recommendations:
- It is necessary correctly to pick up with the help of a podiatrist special orthopedic insoles and heel cushions with a hole in the field of pathology. This will help to fix muscles and ligaments in position, to reduce the load on the calcaneus tuberosity and the fascia and prevent its microreserve. The design of the insole will help eliminate the development of flatfoot by fixing the arch of the foot. Strengthening ligaments and reducing stress on knee and hip joints of the feet relieve fatigue and a feeling of heaviness in the legs.
- Insoles and heel cushions are made from several materials. Silicone well-spring that can support your foot while walking and with proper care, long wear. So it is the best material for orthopedic insoles. Insole of genuine leather is more hard and wear out quickly. Leatherette is not desirable to use. These insoles are «tired of» foot and short-lived. For everyday wear with a slight change in foot are used gel.
- If overweight, a diet to lower it. To drink during the day to 2 liters of water. This will help flush salt from the body.
- Have to do gymnastics. Abandon sports place undue stress on the joints and feet. Help to strengthen the muscles and ligaments of the foot rolling the foot on the floor of cylindrical objects, shifting fingers of the feet from place to place small objects or pulling up to his and towels squeezed my toes without lifting your heels off the floor.
Plantar fasciitis does not manifest suddenly, so timely diagnosis will prevent the development of inflammation and subsequent formation of bony outgrowth from the calcaneus.